Friday, February 22, 2013

Third World Healthcare?



Being home after surgery and 5 days of hospitalization feels wonderful. There is no one to blame but myself for the self inflicted injury I suffered while working outside, but there are many people to thank for helping me while I was hurt and sick.  I will get to that later in the blog.   

In his book, A Pirate Looks at Fifty, Jimmy Buffet writes that travel outside the U.S. changes a person.  The more places and cultures one is exposed to around the world the more one learns, engrained beliefs are challenged and the mind is opened to new ways of thinking.   When I read A Pirate Looks at Fifty I had just turned 50 and what Jimmy said rang true with me.  I had already traveled extensively and lived outside the U.S. and it had been a life changing experience.  My recent hospitalization in a Central American country that is considered by many to be third world was a positive experience that makes me appreciate living in Panama even more.  

Since only about 20 percent of native born Americans have their passport that means around 80% have never traveled outside the country for that eye-opening experience of foreign travel that Jimmy Buffet writes about.  That is easy to understand.  For over 50 years, from sometime after the end of WWII up until sometime before 911, the United States was probably one of the best places on the planet to live.  My grandparents, with the exception of brief trips over the border to Mexico back in the days when it was safe, never traveled outside of the U.S.A.  The same was true for my father.  Nobody retired to Mexico in the 60’s unless they had escaped from prison, as portrayed in the Shaw Shank Redemption.  Today, despite the violence in Mexico, fueled by the U.S. appetite for illegal drugs, many Americans have retired to places in Mexico.  Many other countries are also popular retirement destinations for U.S. citizens who are looking for a better life, better weather and a more affordable daily existence than the U.S. offers.  Some, but not many people initially consider leaving the U.S. in search of better healthcare or to escape the bureaucratic healthcare nightmare that has become the U.S. system, but they should.   

My wife and I do not return to the U.S. frequently.  Collectively we spend less than 6 weeks a years visiting relatives in the U.S.  Twice, I have gone 2 years without a state-side trip.  One of our biggest fears is getting sick or being in an accident while visiting in the United States and having to see a doctor there or even worse, having a health problem that would require hospitalization.  Why?  Because over the last 9 years we have become accustomed to the far superior and flexible healthcare available in Panama, Central America.   The lack of medical bureaucracy, the ease of seeing and communicating with your doctor, the medicines that are available in Panama (and the rest of the world) that are not allowed in the U.S. and, importantly, the ability to have access to this care WITHOUT health insurance.  Health Insurance is not part of our budget.

Early on a Sunday morning when I realized I was in trouble from my injury, Belinda called the surgeon at home on his cell phone and he told us to go immediately to the hospital and that he would be waiting for us.  He was waiting at the admission desk for us, by-passing the emergency room.  First question….”Do you have insurance?”  I answered, “No, I’ll self pay”.  “Good, give us a $300.00 deposit and sign here.  Do you want a private room?” was the concise response.  I took the private room option and was in my room hooked to an I.V. within minutes.  No complicated paperwork, no filling out forms, no delay, no hassle whatsoever.  Just $300.00 and signature and I was being helped by what seemed to be an army of caregivers.       
  
Over the next 5 days there were x-rays, numerous ulta-sounds, a cat scan, an EKG, general anesthesia surgery, lots of I.V. delivered painkiller, antibiotics, temperature and blood pressure checks and pretty good food when I could eat.  There were no requests for money beyond the first $300.00 deposit I made on that early Sunday morning, other than 60 cents for extra coffee.  Remember that I have no insurance.  However, every two days they brought me an itemized accounting of what my bill was up to that moment so there were no financial surprises.

The nurses and the doctors all seemed to enjoy their work and care about me.  When it came time to be discharged from the hospital I did have one question about the bill which was answered and explained within moments with another detailed statement.  Because I am retired, without asking, they surprised me with a 20 percent discount on the already very reasonable hospital charges.   With the swipe of a credit card we were on our way home, feeling grateful to the professional and friendly staff of Mae Lewis Hospital in David, Panama.  Thanks to Dr. Cattan for being so accessible and doing the surgery that brought me immediate relief.  Thanks to Dr. DeGracias for his managing my infection and for being so friendly and interested in me.  Thanks to my wife, Belinda, who made the long trip back and forth to the hospital daily and for taking care of everything on the farm while I was gone.  Thanks to my friend Mike Smith for bringing me really good hot coffee each morning and thus saving me the 60 cents for extra coffee.   Also thanks to those who were concerned and who came to see me.            

Healthcare is an important consideration for those who expatriate from the United StatesLiving outside the U.S. has taught me that there are places where the weather is better, the climate is more agreeable, the cost of living is lower, the food is fresher, the air is cleaner, the beer is cheaper and the health care is superior.  I wouldn’t want to give up any of these things. Thanks Panama.

P.S. If you can afford it, get a passport and follow Jimmy Buffet’s advice and explore the world, learn a new language and explore other cultures.  It will change you.  If you can’t afford to travel it may be because it costs so damn much to live where you are that there are no funds left over for international travel.  If you are not young enough to back pack, use the internet to explore the world and your options for healthcare outside the U.S.  If you are sick and are not getting the care you need in the U.S., consider that many people are discovering, for example, they can travel to Puerto Rico for good healthcare at a fraction of the cost of U.S. based care.  

Sunday, March 18, 2012

Since She Rides Horses 


Good new travels far and wide.  All the way from Texas, my wife's Uncle Doug heard that his niece found a new hobby down here in Panama and he sent the following email to Belinda late yesterday:  "Since the addition of horses in your life, I thought the attached song by Barefoot Man (Cayman Islands) might appeal to Scott!!" 


The lyrics of the song are eerily reflective of reality:

Since she rides horses I don't see her no more
She only comes home to clean her boots and saddle then she walks out the door 
Oh I miss her more than ever before
Since she rides horses I don't see her no more


We all need a hobby we all need our space 
But I'm started to think that four legged stallion has taken my place
Got a fridge full of carrots, can't find a cold beer
And she is burning up my credit card on on her riding gear



Since she rides horses I don't see her no more
She only comes home to clean her boots and saddle then she walks out the door 
Oh I miss her more than ever before
Since she rides horses I don't see her no more



Now I know it is not just ME!  REALLY>>>How accurate can a song get?!!!  Wow!  I have really missed my girl this past year and the nice people at the horse store know me by name....."SeƱor Belinda".  The horse store in Panama City is call El Corcel, but I affectionately call it the FIVE HUNDRED DOLLAR STORE.   I naively thought the most expensive part of buying a horse was actually buying the horse, ha ha ha....as it turns out that the horse purchase is just a bar tab compared to all of the horse related stuff that must be purchased to have a happy, healthy horse....  


For many years I have seen Panamanian horses living outside frequently grazing by the roadside, but these are apparently not happy horses.  They look happy, but they can't be, because they don't get their special 500 dollar store vitamins and don't have a roof over their head....you know, a horse house.  I have learned that the horse house is called a stable.   And, think about it....could a horse be really content and fulfilled without 40 or a 100 acres on which to run, play and fertilize?  I think not.  


The property we found is way, way out in the country.  Perfect for livestock, but no so much for people, lacking a few simple things like electricity, water, garbage collection and pizza delivery....which may explain why there are no people living out here.  Anyway, we had enough money saved up after the move to the country for a swimming pool (it is hot down here) or horse stables.  A swimming pool would have made the heat more tolerable since we have no air conditioning.  AC requires grid electricity.  We break ground on the horse stables next week.   


We are looking forward to getting the horse stables built so Tornado and Apache can check out of their current accommodations.  The two boys currently reside about 45 minutes from here at the Grand Hyatt of Horse Stables in Boquete....it is actually a country club for horses.  They have tennis courts and a swimming pool in addition to their private pedicure guy who trims their hooves.  No kidding.  Anyway, the monthly stable fees and related expenses are about equal to what we paid for each horse.  It would be like buying a new car for $25,000 that cost $300,000 a year and year to fuel and maintain.  What was I thinking?  The only thing that costs more than the stable fees is the diesel fuel and tire rubber that is burned going back and forth to the Boquete Country Club where her two baby boys live in their private Equestrian suites.   

So, I'm looking forward to getting the stables built and we can move the horses onto this property and put them in our private stables.  This is going to save us about $600 per month and if I live to be 168 years old we will get all of our money back by amortizing the land and the construction cost of the stables, which will have hot and cold running water, solar electricity, fridge (for horse treats) TV, an apartment so Belinda can sleep with her horses when they are not feeling well.  Some of you, by now, think I'm kidding and not just embelishing.  Not so....      

Did I mention that our horses cannot eat just plain Panamanian pasture grass that grows naturally?  Our horses get imported Peruvian Alfalfa, which is why Tornado and Apache (we are fairly sure) are so much smarter than all other horses.  It's the diet, plus the excellent training they get from Belinda, who is a great teacher in her own right, but just to be sure our horses get the best possible advantage, she has hired a renowned horse trainer....I think the trainer was in the Olympics or something like that.  Don't even ask me what this is costing....I'm not going to ask.  The trainer really seems to know her stuff and we are lucky to have access to her expertise at any price.  She told us that owning a horse in Panama is MUCH less expensive than in the U.S.  I can not imagine!  Guess we will stay in Panama.

Since She Rides Horses!  It is my new theme song!  But, horses make my Belinda happy and I wouldn't have it any other way!....even if I have to dig my own pool.

Saturday, September 10, 2011

I'll be back...

I write this on the evening of September 10th 2011.  Ten years ago tonight I had just sat down for dinner in the restaurant at the Santa Monica Ritz Carlton (Caleeeforneeea).  You'll get it later.  I ordered a beautiful lobster that I didn't eat....I paid for it and left it sitting on the table looking delicious with a full vodka martini.

My best friend and business partner, Ken Brown, had flown out to the west coast for a dinner meeting with some DIRECTV executives to be held the following evening....the day 911 happened.  That dinner never happened because of the 911 attacks.  We had selected the Santa Monica Ritz, because it was close to Shaztzi on Main...the planned location of our dinner for Tuesday night September 11th, 2001.  Plus, we like staying at Ritz Carlton Hotels....who doesn't?   Anyway....back to dinner, Ken stayed in his room with a cast on his broken arm and took some pain meds, so I was going to dine alone and decadently Ritz Carlton Style, when my cell phone rang.  It was Ken calling from his hotel room asking me where I was.  "In the hotel dining room....Lobster, Vodka....you know, the usual", I replyed.  Ken said, "We've been invited to the Monday Cigar night with ARNOLD at Shatzi's on Main.  He wants to meet us before the DIRECTV dinner tomorrow night.  I can't go because I've already taken my pain pill and washed it down with CC and diet, but you need to go!  I'll meet him tomorrow night at the planned dinner", said Ken.

Well Shit.  About that time my lobster arrived with my next cocktail.  I gave the waiter a hundred dollar bill, not wanting to wait for the check, because I was already late for Cigar night.  I was out the door of the Ritz and in less than 10 minutes I presented myself to the GATEKEEPER at the "Closed to the Public" Shatzi's on Main telling her that I had arrived to have dinner with ARNOLD.   She said "RIGHT...do you know how many people try to get in here on Cigar night?".  She didn't believe I was invited and would not let me in.  I raised my voice at her..."hey! I left a lobster and a martini at the Ritz Cartlon for this!"  So, I gave her my business card and told her to go find FRANCO COLUMBO, former Mr. Universe and Schwarzenegger's best friend....that COLUMBO would vouch for me.  In short order, she returned very apologetic and ushered me into the Restaurant owned by Arnold Schwarzenegger.

That was a great night.  About 20 guys hanging out with Arnold, drinking great beer and smoking Cigars.  Arnold served us huge steaks and baked potatoes and I was seated across from him at the table so he could ask me some questions about why he had agreed to do the dinner the following night, which I gladly explained.  Arnold was friendly, fun and engaging in conversation.  After dinner and more cigars, we shook hands and said..."We'll see you tomorrow night....look forward to it!"   Tragically, the next day was 911 and naturally that second dinner never happened.  The world changed the following morning and I never saw Arnold Schwarzenegger again in person.  I guess his love child was only about 4 years old back then and the maid was much thinner and better looking (I hope), but that has nothing to do with this story....just something I have thought abut since all that came out.

Ken Brown and I hunkered down in the concierge bar of the Ritz Carton Santa Monica for the following 4 days after the 911 attacks with our eyes glued to the TV news.  We finally were able to secure space on the Sunset Limited AmTrak train about the 4th day after 911 and made it as far as New Orleans in another 4 days, where we jumped off AmTrak and make it home by plane for Ken and car for me.  Ken and I drank every drop of brown liquor on that train, but that is a story for another blog, another day.  



          

Thursday, July 21, 2011

Boating and Broken Shit

I guess I have my dad to blame for getting me hooked on boats early on.  He had me at the helm of his 18' Lonestar Cabin Cruiser by age 5....maybe younger.   It was the movie Father Goose with Cary Grant that planted the seed in my head that I wanted a bigger boat....one you could live on when the women folk kicked you out of the house.  Fortunately I haven't gotten kicked out, although Belinda does appreciate an occasional break from me and time to herself in Boquete.  Fortunately, about every other trip, she likes to accompany me to the Hatteras  to enjoy the water and so it was on our most recent six day Caribbean excursion.  The food is much better when Belinda is on board and I truly enjoy her company.  Plus, this time some of her friend girls came out to join us for  a couple of days before moving on to a resort in Dolphin Bay.

After entertaining our friends with a Sunday trip to Rana Azul, the popular Pizza Place in the ''Darklands'' the remainder of my days on the Hatteras were dedicated to broken shit.  The vessel is 36 years old and shit breaks....even the fairly new 12 volt refrigerator that had been running for 3 years without a problem.  A smart neighbor brought his multi-meter over and helped me diagnose the problem.  It needs a new $258 part from the states.  Already bought and shipped....just need someone to bring it down to Panama.  The 19 gallon water heater quit working a while back and was leaking....filling the bildge with water.   Jose, my helper, and I removed it.  I think it is rusted beyond the possiblity of repair, so will look for a replacement.  It had some terrible looking sludge in it that didn't look to healty....and that is where the hot water came from that we used to get our dishes really clean...yuk.  I also had to repair one of the vac-u-flush heads and fortunately had the parts on board.  That is a job that only Jose would help me with.  Poo-poo water involved.

Every trip to the boat involves general maintenence on a variety of systems to keep us dry, in lights and with plenty of fresh water.  We are far from any marina so we have to make our own electricty and water.  I leave the 110 inverter on 24/7 so the locals will have some place to charge their cell phones.  There is no electrical grid on this island nor on the nearby mainland

At night neighbors came over for drinks and dinners.  One night we had steak and lobster.  The lobster was fresh.  A BIG salad, Ken Chester's homemade bread, brots, three bottles of wine filled us up Tuesday night, along with White Russians for after dinner.  Nice.

We arrived back in Boquete yesterday ready for some cool mountain weather.  Next planned trip back to the Hatteras will be the end of this month.  I'll be taking 12 6-volt batteries to change out in the solar system.  There is always something that needs to be repaired or needs maintenence on a boat, but for me that is the fun of owning one.